TOXIDROMES. Searching for Clues. HISTORY. When to suspect Approach to known exposure Approach to unknown exposure. PHYSICAL EXAMINATION. VS Eye exam Skin Neuro. APPROACH TO TREATMENT. Early and effective decontamination Supportive therapy Antidotes Enhanced elimination.
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GI: vomiting, diarrhea
Neuro: tremors, confusion, dysarthria, vertigo, choreoathetosis, ataxia, hyperreflexia, seizures, opisthotonis, and coma
Labs: decreased anion gap
Levels >2.5 meq/L
Not very effective
>3.5 mEq/L (acute)
>2.5 w/ chronic ingestion or renal insufficiencyLITHIUM
SX: trismus, bruxism, tachycardia, mydriasis, diaphoresis, hyperthermia, hyponatremia, hepatic failure, CV toxicity (tachycardia, HTN)
Can result in unopposed alpha effect
If essential consider labetololMDMA “Ectasy”
Careful exam for sexual assaultGHB: Date rape drug“Georgia homeboy, liquid ectasy, or grievous bodily harm”
Can consider urine alkalinizationKetamine: “K”, “special K”